Meta-analysis of the intervention effects of early ambulation on acquired weakness in intensive care unit patients with mechanical ventilation

Abstract

Objective To systematic analyze the intervention effects of early ambulation on ICU acquired weakness (ICU-AW) in ICU patients. Methods The Cochrane Library, PubMed, EMBASE, MEDLINE, CBM, CNKI and Wanfang database were searched via computer for randomized controlled trials on early ambulation to prevent ICU-AW in ICU patients from the data base establishment date to February 10th, 2019.After screening literature, extracting data and evaluating the quality of literature, Meta-analysis was carried out with RevMan 5.3 software. Results Finally, 11 randomized controlled trials were included. Meta-analysis results showed that the incidence of ICU-AW was RR=0.52, 95%CI was (0.41, 0.66) ; muscle strength (MRC-score) WMD=8.08, 95%CI was (6.27, 9.81) ; Barthel index WMD=18.24, 95%CI was (7.27, 29.2) ; mechanical ventilation time was WMD=-1.29, 95%CI was (-1.96, -0.61) ; ICU hospitalization time was MD=-1.81, 95%CI was (-2.78, -0.84) ; total hospitalization time WMD=-3.39, 95%CI (-5.91, -0.88) . Conclusions Based on the present evidence, early ambulation can reduce the incidence of ICU-AW, improve the activity of daily life ability of patients, shorten the duration of mechanical ventilation, length of stay in ICU and hospital, which is worthy of clinical application. Key words: Intensive care unit; Respiration, artificial; Early ambulation; Early exercise; ICU acquired weakness; ICU acquired muscle weakness